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J Am Med Dir Assoc. 2019 May 2. pii: S1525-8610(19)30305-6. doi: 10.1016/j.jamda.2019.03.018. [Epub ahead of print]

Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness.

Author information

1
VA Capitol Healthcare Network, Mental Illness Research Education and Clinical Center, Baltimore, MD; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD. Electronic address: anjana.muralidharan2@va.gov.
2
Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI.
3
Charlie Norwood VA Medical Center, Augusta, GA; Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA.
4
VA Pacific Islands Healthcare System, Honolulu, HI.
5
School of Aging Studies, University of South Florida, Tampa, FL.

Abstract

OBJECTIVES:

Individuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI.

DESIGN:

A multidisciplinary US Department of Veterans Affairs (VA) workgroup of professionals with expertise in geriatric mental health collected voluntary feedback via online questionnaire as part of a quality improvement project.

SETTING AND PARTICIPANTS:

Respondents were mental health providers (N=51) embedded in VA nursing homes called Community Living Centers (CLCs).

MEASURES:

The questionnaire contained multiple-choice, Likert-type scale, and open-ended questions regarding the opportunities and challenges associated with caring for Veterans with SMI in CLCs.

RESULTS:

Respondents identified a lack of training of front-line staff as a key challenge in providing high-quality care to residents with SMI. Specifically, respondents indicated a need to increase staff knowledge about SMI symptoms and diagnoses, to improve staff communication and interactions with residents with SMI, and to decrease mental illness stigma among staff.

CONCLUSIONS/IMPLICATIONS:

The present study revealed significant areas of training need for front-line staff in nursing homes. Many perceived staff training needs overlap with the knowledge and skill set required to provide high-quality dementia care. Integrating training regarding the care of residents with SMI into dementia care training efforts may be a fruitful future direction. Strategies for this and a suggested curriculum are provided.

KEYWORDS:

Serious mental illness; assisted living; long-term care; nursing homes; staff training

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